Mazonia Dialysis LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

License

550003170 Issued in CA

Legal business name

MAZONIA DIALYSIS LLC

Practice address

2977 Redondo Ave
Long Beach, CA 90806-2445

Phone

(562) 988-3418

Fax

(562) 595-5819

NPI assigned

Oct 10, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Samuel T. Wey

Title

VP, Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• EL DORADO DIALYSIS Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

DaVita El Dorado DialysisCCN 552801

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Sep 19, 2016

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

25

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Burlington, WA
  • NPI 1932595584

  Member Of

  NPD member

Affiliated clinicians 6

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Jason Albert Chou, M.D.

  • Nephrology Physician
  • Orange, CA
  • NPI 1083051700

  Dialysis facility

  Care Compare affiliation Name & address match
• Heena M Contractor, M.D.

  • Internal Medicine Physician
  • Los Alamitos, CA
  • NPI 1518954973

  Dialysis facility

  Care Compare affiliation Name & address match
• John T Hsieh, M.D.

  • Nephrology Physician
  • Long Beach, CA
  • NPI 1659376606

  Dialysis facility

  Care Compare affiliation Name & address match
• Kyaw Moe, MD

  • Nephrology Physician
  • Lakewood, CA
  • NPI 1083649735

  Dialysis facility

  Care Compare affiliation Name & address match
• Alice J Park, M.D.

  • Nephrology Physician
  • Long Beach, CA
  • NPI 1649336298

  Dialysis facility

  Care Compare affiliation Name & address match
• Lei Thandar Win, M.D

  • Nephrology Physician
  • Long Beach, CA
  • NPI 1124436001

  Dialysis facility

  Care Compare affiliation Name & address match

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1412899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779321600000",
    "number": "1972907566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2977 REDONDO AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062445",
            "telephone_number": "562-988-3418",
            "fax_number": "562-595-5819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAZONIA DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-10",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "VP, LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "CA",
            "license": "550003170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972907566",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EL DORADO DIALYSIS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Taylor Anice Maynard
• Tamekia Mayo
• Juan Mayorga Jr., LCSW
• Archie R Mays, M.D.
• Asia Mazin
• Michael Mazzarino, LMFT, LAADC
• Blessing Mbuyi
• MC Pharmacy Inc
• Clemmy MC William-Lebusque, AMFT
• Angela McAfee

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Long Beach, CA
• Providers in Long Beach, CA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.